Meningococcal disease is a vaccine-preventable illness caused by the bacterium Neisseria meningitidis. The disease is serious and can be fatal, though about 90% of patients recover with antibiotics.
Meningococcal disease is not highly contagious. Close contacts of cases (household members, daycare center classroom contacts, close friends) are at elevated risk of disease; after a case occurs, these persons should take antibiotics to prevent the infection. School classmates, those living in other dormitory rooms, and healthcare workers attending the case are generally not at elevated risk.
There are 13 different groups, or "serogroups," of Neisseria meningitidis. 90 out of 100 cases of meningococcal disease are caused by groups A, B and C. Other groups are W and Y. Routine vaccinations typically provide protection against groups A, C, W, and Y but not group B. Group B, or MenB, vaccine may be recommended when there are outbreaks of this type of meningococcal disease.
It can take two to ten days for signs of illness to show up after being exposed to Neisseria meningitidis, known as "meningococcal bacteria," but it most often takes three or four days. Meningococcal disease can be spread until the bacteria are no longer in the nose or mouth or for up to 24 hours after antibiotics are started.
Many people confuse meningitis and meningococcal disease, but the two terms are different. Meningitis is one way meningococcal disease can affect the body. Meningitis is an infection of the fluids that line brain and spinal cord. Bacteremia, or a blood infection, is just one other way that meningococcal disease can affect the body. Causes of meningitis include viruses, bacteria, fungi, parasites, amoebas and injuries.
Even when it is treated, meningococcal disease kills about 10 people out of every 100 infected. About 10 to 20 out of every 100 of those who live will suffer disabilities such as hearing or limb loss, brain or kidney damage, nervous system problems, or severe scars from skin grafts.
Who is at risk?
Some people carry people carry Neisseria meningitidis in their nose and throat, without any sign of illness. These people are called “carriers.” In some communities up to 25% of people may be carriers. Typically, less than 1 out of 100 people who get meningococcal bacteria will get sick. Those who get sick often have not been around the bacteria before.
Anyone can get meningococcal disease, but certain people are at higher risk, including:
- Babies younger than one year old
- Adolescents and young adults 16 through 23 years old
- People with certain medical conditions or who take certain drugs that affect the immune system
- Microbiologists who routinely work with meningococcal bacteria
- People at risk because of an outbreak in their community
How is meningococcal disease spread?
Meningococcal disease spreads when an infected person comes into contact with an infected person's nose or throat fluids (droplets from a sneeze, spit, saliva). This happens through close contact, such as:
- Living in the same household
- Coughs and sneezes that are not covered
- Sharing silverware or plates
- Sharing drinking containers (e.g. cups, beer or soda cans)
- Sharing smoking devices (e.g. cigarettes, joints, e-cigarettes)
Meningococcal disease can spread until the bacteria are no longer in the nose or mouth; it can also spread up to 24 hours after antibiotics are started. It is not as easily spread as the common cold or flu. Meningococcal bacteria are not spread through casual contact or breathing the air where an infected person has been.
Always practice good hand hygiene. Use soap and water or 70% alcohol-based hand sanitizer.
- Do not share utensils, drinking containers, smoking devices, toothbrushes or cosmetics.
- Cover coughs and sneezes.
- Take preventative medication, or "prophylaxis," after possible exposure if a health care provider tells you to.
- Get vaccinated.
- Routine meningitis vaccinations are available and typically provide protection against groups A, C, W and Y. Routine meningitis vaccines do not cover MenB. Group B, or MenB, vaccine may be recommended during an outbreak of this type of meningococcal disease. Do not assume that a previous meningitis vaccine will work if health officials recommend a MenB vaccine when there are cases or an outbreak near you. Ask a health care provider if you have questions about your vaccine history or health officials’ recommendations.
Signs and symptoms of illness
Meningococcal disease can progress quickly. Noticing the illness early can prevent serious disability and even death. Early signs of illness are similar to those of other common illnesses and may be hard to recognize.
Meningitis is the most common way meningococcal disease affects the body. Signs of meningitis include:
- Stiff neck
- Sensitivity to light
Meningococcemia, known as “bacteremia” or “sepsis,” is a blood infection caused by meningococcal bacteria. This is the most severe risk and causes clotting of blood vessels, extremely low blood pressure and organ failure. Signs of meningococcemia include:
- Shaking chills
- Severe aches and pains in muscles, joints, chest or belly
- Rapid breathing
When to seek care
People who notice fever along with severe headache, stiff neck, rash or confusion — in themselves or others should contact a health care provider. If the signs of illness are unusually sudden or severe, seek emergency care.
Antibiotics are the usual course of treatment for bacterial meningococcal disease. The disease can progress rapidly if the person does not promptly receive antibiotics.
What is required?
Health Care Providers and Clinical Laboratories
Health care providers and clinical laboratories are required by law to report cases and suspect cases of Meningococcal Meningitis to local health departments within 24 hours of identification.
For Local Health Departments
Model Standing Orders
Although Oregon's meningococcal disease rates are above the national average, it is still uncommon here. Case rates have been declining ever since 1994, when 136 cases were reported statewide. In recent years, groups B and C have each accounted for about a third of cases.
The risk of vaccine-preventable meningococcal disease is low among Oregon college students. From 2010-2014, a total of 127 cases of meningococcal disease were reported to Oregon Health Authority; two of those occurred in Oregon college students. Both of those cases were caused by serogroup Y. College freshmen who want to reduce their already low risk can consider getting meningococcal vaccine.
Please Note: The ABCs project includes only culture-confirmed cases of N. meningitidis, while the case reporting definition, reflected in the Oregon Communicable Disease Summary, includes additional diagnostic results. Therefore, there may be slight differences between the two reports in the number of cases reported for a given year.
Educational materials in multiple languages are available in the Meningococcal Disease CERC Toolkit.